Background:

One in four Americans have a disability but remain an overlooked minority population at risk for health care disparities. Adults with disabilities can be high users of primary care but often face unmet needs and poor-quality care. Providers lack training, knowledge and have biased practices and behaviors toward people with disabilities (PWD); which ultimately undermines their quality of care.

Focus of the Article:

The aim is to identify behavior change interventions for decreasing health care disparities for people with disabilities in a healthcare setting, determine whether those interventions used key features of social marketing and identify gaps in research and practice.

Research Question:

To what extent has the social marketing framework been used to improve health care for PWD by influencing the behavior of health care providers in a primary health care setting?

Program Design/Approach:

Scoping Review.

Importance to the Social Marketing Field:

Social marketing has a long and robust history in health education and public health promotion, yet limited work has been done in the disabilities sector. The social marketing framework encompasses the appropriate features to aligned with the core principles of the social model of disability, which espouses that the barriers for PWD lie within society and not within the individual. Incorporating elements of the social model of disability into the social marketing framework could foster a better understanding of the separation of impairment and disability in the healthcare sector and open a new area of research for the field.

Results:

Four articles were found that target primary care providers. Overall, the studies aimed to increase knowledge, mostly for clinically practices and processes, not clinical behavior change. None were designed to capture if initial knowledge gains led to changes in behavior toward PWD.

Recommendations:

The lack of published research provides an opportunity to investigate both the applicability and efficacy of social marketing in reducing health care disparities for PWD in a primary care setting. Integrating the social model of disability into the social marketing framework may be an avenue to inform future interventions aimed to increase health equity and inclusiveness through behavior change interventions at a systems level.

中文翻译：

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行为改变干预措施的范围回顾，以减少初级保健机构中残疾患者的医疗保健差异：社交营销能否发挥作用？

背景：

四分之一的美国人有残疾，但仍然存在被忽视的少数族裔人口，存在医疗保健不平等的风险。残疾成年人可能是基层医疗的高使用者，但往往面临未满足的需求和质量差的护理。提供者缺乏培训，知识，对残疾人的做法和行为有偏见（PWD）；最终损害了他们的护理质量。

文章重点：

目的是确定行为改变干预措施，以减少医疗机构中残疾人的医疗保健差距，确定这些干预措施是否利用了社会营销的关键特征，并确定了研究和实践中的差距。

研究问题：

通过在基本医疗保健环境中影响医疗保健提供者的行为，在多大程度上使用了社会营销框架来改善PWD的医疗保健？

程序设计/方法：

范围审查。

对社会营销领域的重要性：

社会营销在健康教育和公共健康促进方面有着悠久而稳健的历史，但是在残疾人领域所做的工作有限。社会营销框架包含适当的功能，以与残疾社会模型的核心原则相一致，这支持残疾人的障碍在于社会内部而不是个人内部。将残疾的社会模型的要素纳入社会营销框架可以促进对医疗保健部门的障碍和残疾分离的更好理解，并为该领域开辟新的研究领域。

结果：

发现有四篇文章针对初级保健提供者。总体而言，这些研究旨在增加知识，主要是有关临床实践和过程的知识，而不是临床行为的改变。最初的知识获取是否导致了PWD行为的改变，这些都无法捕获。

建议：

缺乏已发表的研究为调查社会营销在减少初级保健机构中PWD的医疗保健差异方面的适用性和有效性提供了机会。将残疾的社会模型整合到社会营销框架中可能是一种途径，可以为将来的干预提供信息，这些干预旨在通过系统级的行为改变干预来提高健康公平性和包容性。